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Hundreds of GPs fail on CQC premises standards

Hundreds of GPs will have to spend more money on improving the quality of their premises and infection control at their practices in order to avoid closure, the CQC has revealed as it released figures that showed a fifth were non-compliant with at least one of its standards.

In figures that reveal the scale of non-compliance for the first time, the CQC said 20% of GP practices that applied to be registered - 1,545 primary care providers - declared non-compliance with at least one of the CQC’s 16 essential standards.

Premises and infection control were the most problematic areas, with 810 declaring non-compliance on premises and 863 for infection control.

A CQC spokesperson said these rates of non-compliance were expected from the registration pilots they ran at practices, and that any area of non-compliance had been checked by an assessor.

Pulse revealed last month that GP practices have spent an average of more than £2,500 on preparing to register with the CQC, despite the regulator insisting it does not expect practices to spend any additional funds.

But these results indicate that many practices will have to spend more money on revamping their premises to comply with CQC standards.

Pulse reported at the beginning of the month that 7,563 out of the 7,607 providers - 99.4% - that applied to be registered by the 1 April deadline were registered in time, though seven practices have been issued closure notices.

GP practices will now be required to follow through with their action plans to resolve non-compliance agreed with the CQC at the time of registration.

A CQC spokesperson said: ‘This figure is in line with the findings of our pilot last year and was therefore used as part of our workforce and capacity planning for the registration of this sector.’

The CQC has also announced that Professor Nigel Sparrow, medical director for revalidation at the RCGP and a GP in Nottingham, will be joining them as the new National Professional Advisor for Primary Care, to replace Professor David Haslam who is now the chair of NICE.

Last week the CQC also released its strategy and purpose for the next three years, which confirmed that when inspecting providers, practices will be judged on five domains, with inspectors asking whether practices are safe, effective, caring, well-led and responsive to people’s needs.

In an effort to respond to patient complaints, inspectors will look for positive and negative comments about practices on social media sites like Facebook and Twitter. They added that they would introduce a more ‘robust’ registration test for primary care service providers, though added that GPs already registered would not have to go through this process.

Dr Rob Barnett, medical secretary of Liverpool LMC said that the results reflected that some GP practices are in premises that do not meet current standards.

He said: ‘There will be practices that are historically in premises which don’t meet certain standards. If they became practices now they wouldn’t get through. But they are where they are, they’re providing a service and if they can get around the regulation then they should be fine.

‘For example, if you have a problem with access, if people have to walk up flights of stairs to get to the practice then this might be a problem for a patient in a wheelchair. It’s not a problem if you agree to visit that patient at home.

‘GPs shouldn’t have to spend a lot of money- depending on the problem- they should be able to find a way around it.’

‘With Infection control, it clearly depends on what the issue is. We all have a duty to provide care in an infection-free environment. Most of the documentation on this was written for hospitals. So while clearly you can’t have carpets in a room where you’re carrying out hip replacements, it may be ok in a room where you hold face to face consultations.

‘GP practices aren’t hospitals and they shouldn’t be treated like them. I would imagine common sense will prevail on this.’

OutcomeNumber of primary care service providers that declared themselves non-compliant with the outcome
Respecting and involving people who use services291
Consent to care and treatment211
Care and welfare of people who use services258
Meeting nutritional needs58
Cooperating with other providers196
Safeguarding people who use services from abuse523
Cleanliness and infection control863
Management of medicines142
Safety and suitability of premises810
Safety, availability and suitability of equipment237
Requirements relating to workers269
Staffing164
Supporting worker217
Assessing and monitoring the quality of service provision230
Complaints77
Records210
Total1546

Source: CQC

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Readers' comments (16)

  • "I would imagine common sense will prevail on this. I wouldn't - we are, after all, talking about the NHS...

    It is, however, extremely reassuring to hear that the CQC inspectors use validated tools such as "social media sites"...

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  • Suppose a practice simply cannot conform to CQC standards, no matter what e.g. listed buildings, built-up areas where structural adaptaions are simply not possible or are forbidden by local planning.
    Are these practices also going to be closed down by CQC?
    If so, where does any responsibility for the patients lie, and does CQC have any obligations/liabilities in this area, or for the disruption of the local health economy which will inevitably result?

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  • I am concerned that practices are not upto standard as a matter of routine. The contract includes funding to ensure this happens so why arent they?

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  • Mary Hawking

    That would be the LAT as they are responsible for commissioning primary care services. If a provider cant provide service in suitable premises then they should move or loose the contract to some one who can. It will be upto the LAT to ensure patients have access to primary care services.

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  • Orwellian nonsense;the wastage potential for "upgrading " premises is almost limitless.As previous comments suggest most infection control evidence derives from hospitals and surgical facilities. The risk from non invasive consultations are no different to exposure to hairdressers, supermarket checkouts or cinema seats. It's truly dismal at a time of public spending restriction that whimsical bureaucracy is inflicted on a public service with virtually no evidence that waiting rooms kill patients.
    The micro managerial psychosis that afflicted the previous government seems to be more contagious than measles in Swansea.

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  • Comment from the CQC: This is from our online Q&A which might help allay some fears:

    Q: Will my service be closed if my premises don’t meet the required standard?

    A: We know there are concerns about the standard related to the safety and suitability of premises.

    We won’t close your service just because you don’t have modern or state-of-the-art premises. We'll only take action if patients are being put at risk by unsafe premises.

    If your premises don’t meet this essential standard because, for example, you don’t have the correct disabled access, you need to be managing those risks to patients. We'll ask you to tell us how you're doing that when you fill in your application.

    http://www.cqc.org.uk/register/what-being-registered-cqc-will-mean#willmyservice

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  • If practices are closed down by CQC how will the patients registered there access medical care?CQC have decimated standards in care homes,nursing homes and hospitals with their desire for a one size fits all ,featureless service driven by paperwork and protocols .How can we as caring GPs let them erode our autonomy and destroy common sense ,patient centered ,good quality family medicine?I thought I was practising a vocational art as an individual for individuals-not providing a service to clients!

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  • I can tell you CQC has made care worse in my surgery. What do you expect when my practice manager is spending more time on installing protocols rather than ensuring practice runs smoothly, when partners are spending the weekend reading the protocols rather than updating their medical knowledge and my nurses are more concerned about how to address infection control, rather than how to ensure chronic disease monitoring is done.

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  • … and some of you are still not believing that you have been suckered into a bottomless pit.
    Double compulsory regulatory registration (GMC and CQC) is contrary to EU law.
    My advice is for all GPs to cancel GMC registration and only register with the CQC.

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  • I was a GP with over 28 years of experience who took VER recently mainly because of all of this kind of crap being thrown at us.

    In that time I had NEVER seen a patient who had caught some kind of infection from the infrastructure of the building. I saw many who may have well caught an infection from other patients and staff coughing and sneezing etc WITHIN the infrastructure of the building.

    My advice to CQC? Ban patients from entering GP surgeries and it will protect them from preventable infections. You know itakes sense.

    Oh yes. A big thank you to them to make me decide to retire early. The water is lovely and would strongly advise all you 50 something's to do it whilst you can!

    God help the rest!

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